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A randomized, double-blind, placebo-controlled trial of lamotrigine for prescription corticosteroid effects on the human hippocampus.

Authors :
Brown ES
Sayed N
Choi C
Tustison N
Roberts J
Yassa MA
Van Enkevort E
Nakamura A
Ivleva EI
Sunderajan P
Khan DA
Vazquez M
McEwen B
Kulikova A
Frol AB
Holmes T
Source :
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology [Eur Neuropsychopharmacol] 2019 Mar; Vol. 29 (3), pp. 376-383. Date of Electronic Publication: 2019 Jan 03.
Publication Year :
2019

Abstract

In animals, stress and corticosteroid excess are associated with decreases in memory performance and hippocampal volume that may be prevented with agents that decrease glutamate release. Humans also demonstrate changes in memory and hippocampus with corticosteroids. In this report the effects of glutamate-release inhibitor lamotrigine on hippocampal structure and memory were examined in people receiving medically needed prescription corticosteroid therapy. A total of 54 outpatient adults (n = 28 women) receiving chronic (≥ 6 months) oral corticosteroid therapy were randomized to lamotrigine or placebo for 48 weeks. Declarative memory was assessed using the Rey Auditory Verbal Learning Test (RAVLT); structural magnetic resonance imaging (MRI) as well as single-voxel proton MR spectroscopy ( <superscript>1</superscript> HMRS) focused on hippocampus were obtained at baseline and week 48. Utilizing a mixed-model approach, structural and biochemical data were examined by separate ANOVAs, and memory was assessed with a multi-level longitudinal model. RAVLT total scores demonstrated significantly better declarative memory performance with lamotrigine than placebo (p = 0.047). Hippocampal subfield volumes were not significantly different between the treatment groups. In summary, lamotrigine was associated with less decline in declarative memory performance than placebo in corticosteroid-treated patients. Findings suggest that, in humans as well as in animal models, glutamate release inhibitors may attenuate some of the effects on the human memory associated with corticosteroids.<br /> (Copyright © 2018. Published by Elsevier B.V.)

Details

Language :
English
ISSN :
1873-7862
Volume :
29
Issue :
3
Database :
MEDLINE
Journal :
European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology
Publication Type :
Academic Journal
Accession number :
30612854
Full Text :
https://doi.org/10.1016/j.euroneuro.2018.12.012